A red eye is a common complaint, often related to benign conditions. However, a red eye in conjunction with symptoms such as photophobia, pain and decreased visual acuity may be a much more serious disorder.
Intraocular inflammation may result in deleterious structural alterations such as cataracts, synchiae and glaucoma. It may also lead to microvascular leakage in the retina circulation.
Iritis or inflammation of the iris and conjunctivitis can be precipitated by a variety of causes. For example, in addition to infectious causes, allergies and hypersensivity may cause iritis and it occurs as a secondary complication in five to ten percent of patients with ulcerative colitis, and up to 30% of patients with ankylosing spondytitis.
Once the diagnosis is made, treatment with mydriatic and cycloplegic agents with topical corticosteriods is imperative. However, close monitoring is required because overuse of corticosteriods has ominous side effects.
Research in the area of allergic reactions of the lung has provided evidence that arachidonic acid derivatives formed by the action of lipoxygenases are related to various disease states. Some of these arachidonic acid metabolites have been classified as members of a family of eicosatetraenoic acids termed leukotrienes. Three of these substances are currently thought to be major components of what has been previously called slow reacting substance of anaphylaxis (SRS-A) and have been designated leukotrienes C.sub.4, D.sub.4, and E.sub.4 (LTC.sub.4, LTD.sub.4, and LTE.sub.4, respectively).
Another arachidonic acid metabolite, leukotriene B.sub.4 (LTB.sub.4), is a proinflammatory lipid which has been implicated in the pathogenesis of psoriasis, arthritis, chronic lung diseases, acute respiratory distress syndrome, shock, asthma, inflammatory bowel diseases, and other inflammatory states characterized by the infiltration and activation of polymorphonuclear leukocytes and other proinflammatory cells. Thus, when activated, the polymorphonuclear leukocytes liberate tissue-degrading enzymes and reactive chemicals causing the inflammation. Antagonism of LTB.sub.4 should therefore provide a novel therapeutic approach to treatment of these and other LTB.sub.4 mediated conditions.
Because of the debilitating effects of ophthalmic disorders such as iritis there continues to exist a need for effective treatments.